Organization
AVAOCADO MEDICAL GROUP
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1441 AVOCADO AVE, 702, NEWPORT BEACH, CA 92660-7721
(949) 720-9266
Mailing address
8941 ATLANTA AVE # 522, HUNTINGTON BEACH, CA 92646-7121
(714) 299-2666
(949) 438-3868
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G50213
CA
Other
Enumeration date
10/16/2009
Last updated
09/01/2020
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